Objective: To identify differences in compensatory stepping responses (CSR) between Parkinson’s disease (PD) fallers and non-fallers in response to external perturbations. Specifically, to investigate if the side most affected differentiates fallers from non-fallers.

Background: Typically, CSRs are employed to regain balance; and if unsuccessful, a fall may occur. Individuals with PD have CSR with shorter step length and more steps compared to healthy older adults. In order to improve CSR, and thus reduce falls, it is crucial to identify how PD-fallers and non-fallers differ in fall situations. Differences in PD CSR due to perturbations have yet to be compared based on fall history. Moreover, it is unknown if the side more affected by PD can identify disparities in CSR based on fall status.

Methods: Twenty-five PD participants were subdivided as fallers or non-fallers based on self-report of two or more falls in the previous 12 months. All participants completed a static lean and release protocol where an unexpected forward perturbation was employed. Participants performed a CSR that was either: i) natural [no specific instruction]; ii) with their most affected leg first; iii) or least affected first. Spatiotemporal parameters were captured. CSR were compared between groups and side affected.

Results: No significant interactions between groups or trials were found in the natural condition, however an interaction between group and trial was found for the number of steps taken(p=0.012). Fallers took significantly more steps when instructed to step with the more affected side compared to least affected, specifically on the first trial. In contrast, non-fallers took significantly more steps when instructed to step with the least affected side compared to the most affected.

Conclusions: As there were no significant differences between PD-fallers and non-fallers when instructed to make a natural CSR in response to a perturbation, impaired ability to compensate for a fall may not underlie fall occurrence. Interestingly, neither fallers nor non-fallers adapted in subsequent trials. Fallers demonstrated a unique behaviour in comparison to non-fallers, in that they had a diminished ability to respond to a perturbation with the most affected leg. This suggests that fallers may use the least affected side to compensate in fall situations, whereas non-fallers likely do not need to offset their response due to side affected.

« Back to 2016 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/fall-status-and-stepping-response-individuals-with-pd-are-differently-influenced-by-side-affected/